Medical Appeals Specialist

TEKsystems
$21.00 - $28.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, Texas, Addison
May 02, 2025
Description - Review and analyze denied claims, payment discrepancies, and reimbursement issues to identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and accurate submissions. - Prepare compelling appeal letters, supporting documentation, and necessary forms to present a strong case for claim reconsideration. - Stay up-to-date with payer policies, regulations, and industry trends related to claim appeals and arbitration. - Maintain a comprehensive understanding of coding guidelines, medical necessity, and reimbursement methodologies to strengthen appeal arguments. Skills Ms office suite, medical record, medical terminology, medical biller, anesthesia Additional Skills & Qualifications - Proven experience as an Appeals Specialist , AR, denial, NSA experiece or in a similar role within a healthcare setting. - In-depth knowledge of healthcare revenue cycle processes, claim adjudication, and reimbursement methodologies. - Familiarity with insurance denials, appeals, and arbitration processes, including knowledge of payer-specific appeal requirements and guidelines. - Strong understanding of medical coding (CPT, HCPCS, ICD-10) and medical terminology. FULLY ONSITE FIRST SHIFT IN ADDISON, TX Pay and Benefits The pay range for this position is $21.00 - $28.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Addison,TX. Application Deadline This position is anticipated to close on May 9, 2025. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.